Otolaryngology Book

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Sore Throat Symptomatic Treatment

Aka: Sore Throat Symptomatic Treatment, Pharyngitis Symptomatic Treatment
  1. Management: Mild to moderate Pharyngitis
    1. Liquid Acetaminophen
    2. Liquid Ibuprofen
      1. May offer greater relief than Acetaminophen
      2. Requires adequate hydration
    3. Salt water gargles (1 tsp salt in quart warm water)
    4. Diet of smooth, slippery and wet foods
      1. Ice cream
      2. Jell-O
    5. Sucking candies (e.g. butterscotch)
    6. Topical anesthetics not recommended due to Rebound Pain
      1. Topical anesthetic (eg Chloraseptic) throat spray
      2. Soothing throat lozenges (e.g. benzocaine)
    7. Herbal tea containing "Demulcents" (e.g. Throat coat)
      1. Contains Elm bark, licorice root and marshmallow root
      2. Offers short-term relief of Pharyngitis (<30 minutes)
      3. Brinckmann (2003) J Altern Complement Med 9:285-98 [PubMed]
  2. Management: Severe Dysphagia and Odynophagia
    1. Codeine 30-60 mg q4-6h prn severe pain
    2. Trial of oral fluids 20 minutes after pain medications
    3. Diphenhydramine (Benadryl) 25 mg gargles up to qid
    4. Maalox 10 ml swish gargle and spit before meals
    5. Magic Mouthwash (gargle and spit)
      1. 1:1:1 mix of Benadryl, Maalox and Viscous Lidocaine
  3. Precautions
    1. Avoid Systemic Corticosteroids (ineffective) in mild to moderate Acute Pharyngitis (aside from Peritonsillar Abscess)
      1. Hayward (2017) JAMA 317(15): 1535-43 [PubMed]

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